Asma Elsony led the tuberculosis programme in Sudan at the same time as she took her doctoral degree under the supervision of Professor Gunnar Bjune of the Department of General Practice and Community Medicine, University of Oslo in Norway.
During her doctoral degree studies she became President of the International Union against Tuberculosis and Lung Disease as the first African and the first President from south of the globe. During her presidency the Board moved with the DOTs model to other public health lung problems - one of many other achievements.
One of the problems - and this applies to very many countries - is that it takes far too long to diagnose tuberculosis.
"The delay in diagnosis is considerable, regardless of whether people ask for medical help in Sudan, Ethiopia or in a western country such as Norway. Even though a person can already pass on the infection when the coughing starts, it takes on average two months for the correct diagnosis to be made. And then two weeks after the start of treatment for the risk of infecting others to pass," Professor Bjune points out, to the research magazine Apollon at the University of Oslo in Norway.
Worst for the poor
Tuberculosis is an airborne infection and most frequently strikes poor people. The risk of infection is highest in cramped homes with little ventilation. Without treatment half of those infected die - most of them between the ages of 30 and 50.
In the nineties, between 20,000 and 27,000 thousand tuberculosis cases were detected annually in Sudan. The peak was reached in 1999 when so many had finally been treated that fewer were infected. Since then the trend has declined, and the annual figure has now fallen to 16,500.
A total of 230,000 people were treated between 1991 and 2005, when Dr Elsony left the tuberculosis programme.
"This means that under her leadership more than 100,000 people were saved by the tuberculosis programme. But this figure can be multiplied by three: when adults die, many of their children also die from poverty," the professor tells us.
Epidemic centre
There is very little contact between Sudan's 19 universities and the healthcare personnel in rural communities.
"So we really needed an institution that could combine research with public health. To learn more about how to prevent epidemics you need both statistical analyses and substantial contact between research environments and the healthcare personnel in the field," says Dr Elsony.
Three years ago she founded an "epidemiological laboratory" called Epilab.
"It has become the long-awaited link between research and healthcare personnel out in the rural districts. The goal is to cover the whole field where the primary health service needs research support. If healthcare personnel try and fail, and only base their efforts on guidelines, there's a risk of many mistakes occurring," Professor Bjune tells us.
The institution was the first one of its kind in Africa. They used experience from combating tuberculosis to compile complete monitoring programmes for HIV, malaria, asthma and pneumonia as well as for diseases stemming from harm caused by tobacco and industrial pollution.
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